Tag: impingement syndrome

Keys to Managing Your Shoulder Pain

Shoulder pain is a game changer. A painful shoulder can quickly limit the activity level for athletes and non-athletes alike.

The shoulder joint is the most mobile joint in your entire body.  With that being said, eliminating the pain in such loose joint is no easy task.

7 Sports Medicine Tips to Manage Your Shoulder Pain.

Pendulum Swings – With the hand of the pain-free shoulder resting on a chair and a 10-15 lbs weight in the other hand, slowly move the weighted hand in a slow circular motion.  This will distract and relax the muscles surrounding the painful shoulder joint. Swing the hand/arm like a pendulum in both clockwise and counter-clockwise directions.

Pliable Chest Muscles – Longer and more flexible chest muscles are vital for a happy pain-free shoulder. Start by aggressively massaging the deep chest muscles with fingers or a baseball (warning; it hurts but it works). Next, stretching the superficial chest muscles in a door frame is a simply way lengthen your broad, strong chest muscles.  By doing so, the more flexible chest muscles will now allow for greater mobility of three (3) bones which make up your shoulder girdle (upper arm bone, shoulder blade & collar bone).

Strong Shoulder Blade Stabilizers – You have 17 muscles anchored to each of your shoulder blades.  Keeping your upper back strong helps protect the shoulder joints by controlling the intricate motions of the shoulder blade.  To do so, seated rows, bent-over flies, cable “T’s” and good ol’ scapula squeezes need to be part of your shoulder plan.

Enduring External Rotators – Of the four (4) muscles forming your rotator cuff, the two external rotators are the most important when it comes to prevent shoulder injury.  The key factor with shoulder external rotators is not just strength. Hence, having great endurance of the external rotators should be your goal.  Doing high repetitions (>15 reps) using cable weights or simple exercise bands will help accomplish this.

Overhead Stretches – Add low-intensity pain-free overhead stretches to your routine. Examples include 25-50% body weight hangs from a pull-up bar/door frame or bend-over stretches with hands on a high counter.

Limited Overhead Strengthening – Anytime you perform strength work above your shoulder level, you’re increasing the stress on your rotator cuff. You can sufficiently strengthen all your shoulder, back and chest muscles without ever elevating your elbows above your shoulder.

Strong Posture – Daily tasks like driving, working on a computer and carrying objects all contribute to poor posture and shoulder pain.

Strong posture = Shoulder blades “back and down” + chin over ribs

The Quest for Happy Shoulders

Most of the painful shoulder joints I treat have key problems related to their shoulder girdle. These 7 sports medicine tips will help you protect two very important joints.

Remember this simple formula: Happy shoulders have mobile shoulder girdles, great endurance of their external rotators and strong upper back muscles.

Subacromial Bursitis Made Easy

Subacromial Bursitis Made Easy

Understanding Shoulder Bursitis

The subacromial bursa is a thin, sac-like structure located just under the acromioclavicular, or AC, shoulder joint. It acts as a lubricating buffer between the rotator cuff, undersurface of the lateral clavicle and scapular acromion process.

Specifically, the bursa’s main function is to reduce friction in the upper layers of the rotator cuff and humeral head during shoulder motion.  As a thin, fluid-filled sac, similar to a slim water balloon, it is quite efficient at specifically doing so with respect to the head of the humerus, long-head of the biceps tendon and the (all-important) rotator cuff.  Given the level of motion and stress associated with the shoulder joint, the subacromial bursa certainly faces a trying task every single day. However, this does not even involve direct contact with the shoulder girdle.

Rotator cuff tendonitis and shoulder impingement syndrome are other conditions commonly associated with chronic subacromial bursitis. Additionally, it is not unusual for a chronic rotator cuff injury that alters shoulder joint mechanics to result in subacromial bursa inflammation. It is therefore extremely important to assess for any additional upper extremity or torso imbalances/injuries that require treatment when an athlete presents with a bursitis involving the shoulder.

Signs & Symptoms of Subacromial Bursitis

  • Generalized stiffness of the shoulder joint, mostly on the top and front of the shoulder
  • Symptom escalation generally associated with either a direct blow to the front of the shoulder joint or increased shoulder use, usually involving overhead-type activities
  • A sense of weakness or loss of strength with activities involving the shoulder
  • Localized puffiness or a pocket of swelling in the upper-front area of the shoulder, just below the AC joint, which becomes more evident when the arm is extended at the shoulder
  • Weakness with active shoulder elevation and abduction

Professional Treatment for Subacromial Bursitis

  • Eliminate all routines that contributed to the bursitis. This can include excessive overhead activities, trauma or contact to the shoulder, weight training above shoulder level, painful motion during activities of daily living (ADLs) or carrying heavy objects like luggage with the affected shoulder.
  • Consistently ice the front, top and back of the shoulder.
  • Utilize available therapy modalities to decrease pain and swelling.
  • Do easy pendulum swings with no more than 5 pounds of weight.
  • Perform passive and pain-free range of motion (ROM) shoulder joint exercises, to include flexion, abduction, horizontal abduction and external rotation. At the same time, minimize shoulder extension and horizontal adduction motions.
  • Employ progressive resistive strengthening of external shoulder rotation, if pain free.
  • Avoid sleeping on the affected shoulder if still swollen and/or painful.

Ask the Right Questions Like a Pro

Here’s what smart pro athletes would ask their sports medicine specialist to ensure a fast and safe return to the game they love:

1. Is this an isolated bursitis, or do I need to treat other shoulder issues as well?

2. Is my rotator cuff damaged?

3. What do you believe caused this injury, and how can I avoid these types of injuries in the future?

4. Should I expect future anti-inflammatory injections for this bursa?

Elite Sports Medicine Tips from Mike Ryan

  • Looks Can Be Deceiving – Bursitis often looks worse than it feels.
  • Get it Right the First Time – Don’t let the lack of initial pain fool you – with the bursa’s proximity to the rotator cuff, seek swift, appropriate treatment to avoid a chronic nightmare.
  • Ice, Ice Baby – It’s said time and time again, but the “ice thing” is a key tool to quiet down bursitis and reduce localized swelling.
  • Pinpoint the Source – If the reason for bursa swelling is unknown, dig deeper to find out why.  Quickly finding the source helps avoid major shoulder complications down the road.
  • Avoid the Knife – Some doctors are quick to offer a “simple surgical solution.”  Run away quickly and reread this article.